You will need to sign on with your LLLID (La Leche League ID) before you can post. If you have never claimed your LLLID, create your LLLID now. To sign in, click the LLLID Sign On button in the upper right corner. Enter your LLLID Alias and click the button again.

When will milk come in??

I gave birth via c-section on March 2nd as a first time mom and I still have no milk. I have colostrum but am having to supplement with formula via a small little tube that is taped to my breast during each feeding. Thus, my breast is stimulated and she is getting what she needs for nourishment. I nurse her every 3-4 hours as that seems to be when she's hungry. I nurse on each breast for 15 minutes each. I'm wondering how long it will take and/or how long do I wait before I throw in the towel? Also, what can I do to speed up the process?

Re: When will milk come in??

Congratulations on your new little one! Don't throw in the towel! Sometimes it just takes a little (or a lot) longer for milk to come in, especially if there was any disruption in the course of birth. You're already well ahead of the game doing all your supplementing at the breast instead of in a bottle.

Every 3-4 hours is not terribly frequent to be nursing. I'm not sure how much of a to-do it is to nurse with an SNS, but it might help your milk come in faster if you could nurse every 2 hours or so. Maybe you wouldn't even need the SNS for every single feed, if she's not terribly hungry at some of them.

My best friend's son was in the NICU for almost 2 weeks, and it took her 10 days of pumping round the clock to get her milk to come in, but it finally did, and she went on to nurse him with no difficulties.

Re: When will milk come in??

First I want to understand why you think your milk has not "come in." Many moms beleive they do not have enough milk when all is normal. Milk "coming in" is really just the transition from colustrum to more abundant milk, and it can be quite gradual and is not always a dramatic and obvious event. So please explain what is happening that makes you think all you are making is colustrum.

Many things can cause low milk supply or prevent effective milk letdown. Is nursing painful? Are you still on strong painkillers for the c-section? Is there any possibility some of the placenta was left in you? Is baby able to latch and nurse effectively?

Also I agree with pp. A newborn would typically nurse a minimum of 10-12 times in 24 hours and some nurse way more. Are you holding your baby lots and nursing on the earliest cues? If you do not like using the lactation aid, try adding on some additional nursing sessions without the lactation aid and see what happens.

If you were given a lactation aid I assume you had access to some lactation services. They need to be following up with you (or you with them.) If you indeed need to supplement, that is an issue that is not solved by using a lactation aid-or rather, the aid solves the immediate issue of baby getting enough, and its a very helpful tool as you avoid the pitfalls of bottles and yes, have stimulation at the breast. But what is being done to solve the milk supply issue? If you truly have low supply, there is much more you could be doing. But I suggest you figure out if indeed that is the problem.

Re: When will milk come in??

My advice is to nurse more often. At least every 2 hours if not more. Also remember that colosturm is MUCH higher calorie than BM and only a very small amount needs to be consumed for baby to get as much as they need. Sometimes supplementing can delay the milk. Honestly, what I would say is to just nurse every single time baby acts hungry. Without the supplementer. Even if that's every 20 minutes. Nothing will help you produce more milk faster than nursing very very often. My DD2 is 6 months old and still nursing every 2 hours. Good luck!!!

Re: When will milk come in??

Thank you all for responding. I'll try to answer your questions to give you a better idea of what I'm experiencing.

-My baby weighed 7lb 10oz at birth on March 2nd.
-I started breast feeding right away 15 minutes each side and it seemed like it was every 3-4 hours then. There was no mention by nursing staff that I should be doing it sooner.
-My baby kept sucking on her hands and being fussy and it was recommended that I give a pacifier as it wouldn't be good to allow the baby to use my breast as a comfort measure if she wasn't hungry....which led me to believe that she needed to be "pacified".
-On March 4th my baby had lost nearly 10% of her body weight and thus it was recommended I start supplementing. We started with 15 minutes breast feeding each side followed by formula from a bottle..about 1 oz.
-Baby tolerated that okay, but wasn't the best with the bottle...seemed to have a lot of spit-up and/or wasn't swallowing as well. At any rate, the next time I went to breast feed her she wanted nothing to do with my breast. I was a bit discouraged but nursing staff helped me with using a syringe to get the taste of milk in her mouth and then she would suck on my breast. However, once the taste of formula went away she no longer would suck and didn't want my breast.
-It was at this time when another nurse suggested the assist device and I've been using that since.
-Baby has latched great since the very beginning.
-I last had narcotics last Wednesday and I take 800mg IBP as needed which usually is 1-2 times per day.
-Nursing hasn't been painful at all. I put the Medela lanolin on my nipples after each feeding.
-Baby had her first pediatrician visit last visit and had gained back 3oz.
-I don't believe there is still any part of the placenta inside me. My bleeding slowed way down and haven't had cramping, etc.
-I hold my baby a lot but didn't realize I needed to offer my breast with any little sign of hunger so I appreciate your advice on this.
-I feel as though my milk hasn't come in because when I self-express (which is once in a great while just to see if anything is still coming out of my breast) it is still clear and colostrum looking; my breasts have not changed at all since giving birth; I haven't had engorgement, heaviness, leaking, etc from my breasts. Essentially, aside from minimal soreness of my nipples that I've had since I found out I was pregnant, my breasts haven't changed at all. I keep waiting for the "oh you'll know when your milk comes in."
-There wasn't a lactation consultant at the hospital where I delivered....unfortunately....so I had to rely on the nursing staff to give me advice, etc.

If there is other advice you can offer me now I would appreciate that too. I'm am trying today to nurse her at every sign of hunger and we'll see what happens. It's hard for me to stay dedicated to breast feeding at this point.

Re: When will milk come in??

. I think what is happening to you is what happened, to sme extent, with my first.

That pacifier.

My own mother suggested I use it because he was nursing every hour. And little did I know, that is normal. Fortunately, I had already been given advice to pump after every feeding, and I naturally tend to OS and OALD, so he gained OK. But if I was normal in production, that pacifier can derail breastfeeding because baby needs to suck at the breast to bring in your milk fully.

A few thoughts I have:
Nurse more. Yes, wake the baby. Dream feed. Nurse more.
Feed with the SNS.
Start at the breast, give a bottle, then always end at the breast.
Spend 3 days doing nothing but watching wets and loops and nursing.

You can come back. I fought nipple confusion/preference with my oldest child for 8 weeks before he stopped fighting me at every feeding. And then I nursed that baby for 2 years You can overcome.

Meanwhile, pitch the pacifier and hold off on the bottles. The pump still has a place; try pumping after baby nurses, and try pumping one side while nursing the other.

Re: When will milk come in??

Thank you so much, Susan! I was never told to pump after every feeding so I never have. I rented a hospital grade medela pump and have had it at home since the day I was discharged from the hospital. I just got it out and pumped in the last half hour and low and behold I got some milk out. I got probably a 1/2 oz from my right breast and less than that from my left. It did give me some hope! I'm sure that's not enough to keep baby satisfied. I will definitely use your suggestions. Thanks again!

Re: When will milk come in??

EDIT:Whoops! I was writing this long post and did not see that you are now pumping and saw milk. Well, your milk has finally come in! Congratulations! Normal output for one pumping session at this point if a mom is also nursing would be about 1/2 ounce to 2 ounces total. So, you are looking really good, imo. So, some of what I have posted below may be too cautious. You may be able to reduce the supplementing much faster than I was thinking. Your milk is there, now nurse nurse nurse! (end Edit)

-My baby weighed 7lb 10oz at birth on March 2nd.
-I started breast feeding right away 15 minutes each side and it seemed like it was every 3-4 hours then. There was no mention by nursing staff that I should be doing it sooner.
-My baby kept sucking on her hands and being fussy and it was recommended that I give a pacifier as it wouldn't be good to allow the baby to use my breast as a comfort measure if she wasn't hungry....which led me to believe that she needed to be "pacified".

Agree with pp. The above sounds like a recipe for harming milk supply. I am so sorry you had such terrible advice in the hospital but by no means am I surprised. I am also not surprised your baby lost 10% of birth weight, for one thing, some weight loss-up to about 10% is often perfectly normal after birth, and in this case it looks like your baby was simply were not nursing enough. You should have been encouraged at that point to simply nurse more. A 10% loss of birth weight is only slightly higher than average and likely supplements were not even warranted.

OK, so now to fixing the problem: You say

-I feel as though my milk hasn't come in because when I self-express (which is once in a great while just to see if anything is still coming out of my breast) it is still clear and colostrum looking; my breasts have not changed at all since giving birth; I haven't had engorgement, heaviness, leaking, etc from my breasts. Essentially, aside from minimal soreness of my nipples that I've had since I found out I was pregnant, my breasts haven't changed at all. I keep waiting for the "oh you'll know when your milk comes in."

Leaking means nothing, some people leak and others do not and it has nothing to do with supply. Engorgement means little and is something you want to avoid anyway, if possible. But your breasts would normally have some heavyness or change in feeling, usually sometime between day 2 and day 6 after birth. And its odd the milk is still "clear." I don't know what to make of that. One thing to know is that pumps are less effective than well nursing babies at extracting milk-sometimes dramatically so. How are you expressing the milk? With a pump? A good pump? Hand expression, what? Is it usually right after a feeding or later?

I think its too early to know if this is just a milk supply issue brought about by nursing mismanagement in the early weeks, (my guess) or some type of physical condition that is preventing mature milk.

If you can see a private lactation consultant for an appointment I would strongly encourage you do so. They should spend about 90 minutes with you and really help you get to the bottom of things. Get recommendations from local LLL, doctor, friends, the LC at the hospital, anyone, and call a couple to find one who can see you soon and who you feel comfortable with. It may be very helpful to do some before and after nursing weight checks to see what baby is actually getting at the breast without the lactation aid. You want to do more than one, as one is not enough to draw accurate conclusions from. I would say do at least 3.

The good-really, great news, is that you have kept baby nursing at the breast. This is vital, because the most important thing to do when trying to increase milk supply is to have baby nurse frequently. If you have a good pump and can add a few pumping sessions a day as well, do that, but DO NOT stress about what you are making and what is looks like. Just pump to give extra stimulation if baby won't nurse more. It would be great if baby could be nursing a minimum of 12 times a 24 hour day.

Your goal will be to slowly decrease the supplements while nursing more. It may be hard to get baby to nurse more without first reducing the supplements. Moms in this situation are of course nervous about reducing supplements, but it is part of the process. This can be a tricky time and it is best to do this under the care of a lactation consultant or a breastfeeding knowledgeable and supportive pediatrician.

Remember that many many moms struggle with low supply (or suspected low supply) in the early days and go on to nurse their babies just great. This is likely fixable, especially since this is such early days and hormonally your body will be working with you in increasing supply. It will take effort but I have never heard a mom say that effort was not worth it.

Re: When will milk come in??

To be honest, I didn't start producing enough milk until 6 days after I returned home from the hospital... by then over a week has gone by and my poor baby wasn't getting anything in the meantime. I would still pump and massage, but nothing would come out until the end of day 6 (and even then, it was only a few drops). We ended up having to supplement with forumula until I was able to produce more. Don't give up! Your breastmilk will increase gradually until you no longer need supplementation!! Hang in there

Re: When will milk come in??

I say go and buy the latest Womanly Art of Breastfeeding book and read it cover to cover. It's a awesome book. As every one else said ditch the pacifer. When some one gives you advice (and plenty of people will!) I try to think of things organically! Before there was....before there was formula what would some one do? Before there was pacifers what would some one do? Before there was x what would some one do? You get it? We are alive today with thousands of years of humans living with out modern things, like formula, pacifiers, etc etc, so, obviously they are not as needed as some people would lead us to believe. Ditch the pacifiers, there is absolutely nothing wrong with a baby using you as a pacifier in fact that will help your milk production! babies are not manipulative, they know their needs and they aren't trying to con people into things they don't need....so when they cry cause they want to pacify at the breast it's a real need, and is just fine for you to use your breasts for that. It will not spoil them, or what ever else people say it will do...it's totally natural and best thing for baby...has no orthodontic problem making either, like a pacifier can tend to do!